Medical Records
We strive to make it as easy as possible for you to obtain a copy of your medical record. Please note that in compliance with state and federal laws, all requests must be submitted in writing, form be completely filled out and signed with a witness signature.
How to request your medical record
The first copy of a record is free, but additional copies thereafter has a charge of $1.00 per page. However, if records are being sent to another physician, the fee will be waived.
Submit the Form
The completed and signed form may be mailed, faxed, or delivered to:
Livingston Hospital
Attn: Health Information Management Services Department
111 E Main St.
Salem, KY 42078
270-988-7233 or 270-988-7250
Fax: 270-988-4327
How to request your medical record
- Contact the Medical Records Department at 270-988-7233 or 270-988-7250
- Stop by Livingston Hospital, Monday – Friday 7:30 AM to 4:30 PM
- Download the Livingston Hospital release form
The first copy of a record is free, but additional copies thereafter has a charge of $1.00 per page. However, if records are being sent to another physician, the fee will be waived.
Submit the Form
The completed and signed form may be mailed, faxed, or delivered to:
Livingston Hospital
Attn: Health Information Management Services Department
111 E Main St.
Salem, KY 42078
270-988-7233 or 270-988-7250
Fax: 270-988-4327
